Just over a year ago, after a massive explosion in the parking area of Al-Ahli Arab Hospital in Gaza killed 471 people and wounded hundreds more, plastic and reconstructive surgeon Dr. Ghassan Abu-Sittah, who was performing surgery at Al-Ahli when the roof fell in, gave an extraordinary press conference. Flanked by fellow health care workers in their scrubs and surrounded by white-shrouded dead bodies in the hospital courtyard, Abu-Sittah, a British-Palestinian volunteer in Gaza with Doctors Without Borders, described how people came to the hospital in search of safety.

“This is a war crime that the world has seen coming,” he declared. “Israel has been warning the entire world that it was going to attack Palestinian hospitals, and it did exactly that.”

While Israel has denied responsibility for that specific attack, whose origin is still debated, since then, Israeli forces have directly attacked hospitals and other health care facilities dozens and dozens of times.

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In a recently-released investigation that was presented to the United Nations General Assembly on Oct. 30, the U.N.-mandated independent Commission of Inquiry found that Israel has implemented a concerted policy to destroy the health care system in Gaza, and that it has committed the crime against humanity of “extermination.”

Salon previously reported the findings of the COI, which covers allegations from all sides in the region from Oct. 7, 2023, through the end of July 2024, and explored how they relate to the ongoing impact of Israel’s continued and intensifying operations in Gaza on health care facilities, staff and patients, an impact documented by other organizations. These include a report on the killing, detention and torture of health care workers released this month by Healthcare Workers Watch, a correspondence published last week in the Lancet documenting a surge in preventable maternal and neonatal deaths in Gaza, and a new report from the U.N. Special Rapporteur on the situation of human rights in the Palestinian territories occupied since 1967, Francesca Albanese, that addresses the worsening humanitarian crisis in Gaza.

While the evidence of Israel’s repeated and deliberate attacks on health care infrastructure has been presented to the world, many health care professionals and their patients have asked the international community why their calls for intervention are being ignored — and wonder where the solidarity is with health care workers in Gaza.

Distribution of medical aid and medicines to Nasser Medical Hospital in the city of Khan Yunis, south of the Gaza Strip, which recently arrived through the Rafah crossing on October 29, 2023 in Khan Yunis, Gaza. (Ahmad Hasaballah/Getty Images)“Nothing in this war makes sense, the entirety of it is unimaginable! I hope it ends soon, but no one seems to be trying to stop it,” Dr. S., a physician who worked in a north Gaza hospital until he and his family were displaced and the hospital was later attacked, raided and put out of service, wrote to Salon in a series of text messages. (Salon has agreed to protect his identity.) Dr. S. was trapped in Gaza when he returned home days before Oct. 7, 2023, to celebrate his graduation with family members he hadn’t seen during 10 years of medical studies abroad. He has lost 72 family members to Israel's attacks.

“In the midst of the devastating conflict in Gaza, doctors and medical staff are caught in an unimaginable crisis,” S. said. “The health care system, which should be a sanctuary in times of war, has instead become a target. Hospitals are under siege, and medical professionals, who are doing everything in their power to save lives, are under direct threat. Doctors are being attacked, kidnapped and killed, while the very institutions meant to provide care are being bombarded. Yet, the world remains largely silent on their plight. While there is global outrage over civilian casualties, the relentless attacks on the medical community remain underreported.”

On Nov. 8, 2023, another unique press conference took place in Gaza. This time it was at Al-Shifa Hospital, then the largest in the Gaza Strip. Standing outside the hospital, Palestinian children called on the world to prevent their deaths. The first young speaker stated in English, “We come to Al-Shifa Hospital to keep us from bombing. We suddenly run out of death more [sic] after bombing the hospital.”

On Nov. 11, the IDF laid complete siege to Al-Shifa Hospital, claiming that Hamas used it as a command and control center.

By Nov. 12, the World Health Organization, UNFPA and UNICEF’s regional directors jointly called for international action to put a halt to Israel’s attacks on hospitals, reporting that 137 attacks on health care infrastructure had already resulted in 521 deaths, including those of 16 medical workers. The attacks described in the COI report and documented since the period studied there by others, like Healthcare Workers Watch, Forensic Architecture, Human Rights Watch, other U.N. bodies and numerous media organizations, don’t just include hospitals. They also involve ambulances, which health care staff rely on to save the lives of people too badly injured to get to a hospital on their own. As the report states:

As at 15 July, 113 ambulances had been attacked and at least 61 had been damaged. The Commission documented direct attacks on medical convoys operated by the International Committee of the Red Cross (ICRC), the United Nations, the Palestine Red Crescent Society and non-governmental organizations. Access was also reduced owing to closure of areas by Israeli security forces, delays in coordination of safe routes, checkpoints, searches or destruction of roads.

The U.N. commission devoted special attention in its report to particularly egregious allegations, one of which was the story of five-year-old Hind Rajab and her family, and the paramedics who tried to save her life.

On Jan. 29, a car carrying Hind and her cousin, 15-year-old Leyan Hamada, as well as Hind’s aunt and uncle and three other cousins, was attacked by Israel Defense Forces while trying to evacuate from an area under heavy bombardment. After the adults in the car were killed, Leyan tried to call for help and got through to the Palestinian Red Crescent Society.

“They are shooting at us. The tank is right next to me. We're in the car, the tank is right next to us,” she told the PRCS dispatchers before they heard her screams and the sound of machine gun fire. When the dispatchers called back, Hind answered and told them her cousin was dead.

The little girl was trapped alone in the car for hours after that, using her cousin’s phone to beg PRCS staff for rescue, telling them, “I'm so scared, please come. Come take me. Please, will you come?" As described in the U.N. commission report, the dispatchers contacted the MOH and Israeli security forces to coordinate, over hours of negotiation, a designated safe route they might take to rescue the child — which is standard practice in conflict situations — and when finally given the green light, dispatched an ambulance with two paramedics.

"Nothing in this war makes sense, the entirety of it is unimaginable!"

When the ambulance was roughly 50 meters from the family’s car, it was struck by a tank shell. Twelve days later, after the Israeli military finally withdrew from the area, the family members’ bodies, including Hind’s, were retrieved from the bullet-ridden car. The ambulance was also found nearby, totally destroyed and with human remains inside.

“The number of bullet holes in the car indicates [it] was being deliberately fired upon,” Chris Sidoti, one of the three members of the independent COI, told Salon in a video interview, citing “hundreds of bullet holes.” The condition of the ambulance suggested it had been struck by a tank shell, Sidoti........

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